This approach enabled the surgeon to correct the deformity in all planes simultaneously, with a clearer visualization of the anatomical structures. Emphasis was placed on correcting the foot position to neutral and in particular avoiding over-correction. The corrected foot position was maintained by inserting three pins at the time of surgery, which were removed 6 weeks later. Serial casts were used for a period of 16 weeks. Tarso-pronator boots were used to maintain correction in the ambulant child.